Primary therapy of Graves' disease and cardiovascular morbidity and mortality: a linked-record cohort study

Publication date: Available online 28 February 2019Source: The Lancet Diabetes & EndocrinologyAuthor(s): Onyebuchi E Okosieme, Peter N Taylor, Carol Evans, Dan Thayer, Aaron Chai, Ishrat Khan, Mohd S Draman, Brian Tennant, John Geen, Adrian Sayers, Robert French, John H Lazarus, Lakdasa D Premawardhana, Colin M DayanSummaryBackgroundGraves' disease is routinely treated with antithyroid drugs, radioiodine, or surgery, but whether the choice of initial therapy influences long-term outcomes is uncertain. We evaluated cardiovascular morbidity and mortality according to the method and effectiveness of primary therapy in Graves' disease.MethodsIn this retrospective cohort study, we identified patients with hyperthyroidism, diagnosed between Jan 1, 1998, and Dec 31, 2013, from a thyroid-stimulating hormone (TSH)-receptor antibody (TRAb) test register in south Wales, UK, and imported their clinical data into the All-Wales Secure Anonymised Information Linkage (SAIL) Databank (Swansea University, Swansea, UK). Patients with Graves' disease, defined by positive TRAb tests, were selected for the study, and their clinical data were linked with outcomes in SAIL. We had no exclusion criteria. Patients were matched by age and sex to a control population (1:4) in the SAIL database. Patients were grouped by treatment within 1 year of diagnosis into the antithyroid drug group, radioiodine with resolved hyperthyroidism group (radioiodine group A), or radioiodine with unresolved hyperthyroidism ...
Source: The Lancet Diabetes and Endocrinology - Category: Endocrinology Source Type: research